By Ron Winslow, Wall Street Journal
Americans are living longer than they did two decades ago, but they are losing ground on key measures of health to people in other developed nations, a study shows.
The findings, from the most comprehensive analysis of the health of the U.S. population in more than 15 years, show progress in reducing death rates, adjusted for age, across a variety of diseases. But death rates from illnesses associated with obesity, such as diabetes and kidney disease, as well as neurological conditions like Alzheimer’s disease, are on the rise.
Meanwhile, the number of years of living with chronic disability, an indicator of quality of life, rose for the average American in the past 20 years, partly reflecting increased longevity.
Despite gains in longevity, Americans are living the extra years “not necessarily in good health,” said the researchers, led by Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.
The study was published Wednesday by JAMA, the Journal of the American Medical Association. Murray also presented the results, along with separate reports on physical activity and obesity in counties across the U.S., at a White House event hosted by first lady Michelle Obama as part of her campaign against childhood obesity.
Murray said the U.S. has also made important headway against such problems as strokes; certain cancers, including colon and breast cancers; and HIV, the virus that causes AIDS. “It’s important to recognize that there are some areas where we do well,” he said.
With annual health-care outlays in the U.S. totaling nearly 18 percent of gross domestic product, according to federal data, outside experts cast the study’s findings in economic terms.
“Despite a level of health expenditures that would have seemed unthinkable a generation ago, the health of the U.S. population has improved only gradually and has fallen behind the pace of progress in many other wealthy nations,” said Harvey V. Fineberg, president of the Institute of Medicine, in an editorial accompanying the report. The IOM advises the government on health matters.
In every measure examined, including life expectancy and quality of life, Fineberg said, the U.S. ranking fell among the 34 members of the Organization for Economic Co-operation and Development, a think tank for developed countries.
Michael Roizen, chief wellness officer at the Cleveland Clinic in Ohio, said the findings put the U.S. at a disadvantage in the global job market. But he said much of the problem could be addressed by better diet, smaller food portions, increased physical activity, quitting smoking and better management of stress. “They are things we totally have control over,” he said.”It’s a matter of us getting serious about this.”
The analysis was based on data for 291 diseases and 67 risk factors for disease, as well as a variety of government-sponsored health surveys. It included data from 187 countries, making it one of the most ambitious efforts undertaken to assess the disease burden not only in the U.S. but around the world.
In the U.S., life expectancy rose three years to 78.2 years in 2010 from 75.2 in 1990, researchers found. But the nation’s ranking among OECD countries fell to 27th from 20th 20 years earlier.
A doctor examines a patient in Miami earlier this year. Life expectancy in the U.S. rose three years to 78.2 years in 2010 from 75.2 in 1990.
Moreover, people were in good health, or without short- or long-term disabilities, for just 68.1 of those years on average, the report found. The gap of 10.1 years between total life span and a healthy life span rose from 9.4 years in 1990, and the U.S. ranking for a healthy life span fell to 26th from 14th two decades ago.
Despite progress on cardiovascular disease and some cancers, the lead causes of premature death in the U.S. remained heart disease, lung cancer and strokes. Leading contributors to disability were lower-back pain and other disorders of muscles, nerves and joints, as well as depression and anxiety.
While many chronic disabling conditions play only a limited role in premature death, they are major drivers of health-care costs, Dr. Murray said. “We are not very good at preventing them or curing them and only mildly good at treating them.”
Researchers also found that poor dietary habits have overtaken smoking as the most important risk factor associated with years of life lost to disability and to premature death.
Findings from the county studies presented at the White House show a substantial increase in physical activity, including in Kentucky, a state that traditionally has trailed in healthy living habits. But over 20 years, he said, not one county in the U.S. reduced the burden of obesity among its residents.
For Sister Donna Hawk, who left a job as a hospital chaplain at the beginning of this year, the link between longer life and potential disability came into focus when she recently turned 70. Her father died just before turning 70, having had two open heart surgeries, and other family members had similar problems. She herself has seven stents in her heart, and had been overweight.
“So I’m thinking in their older age, they weren’t as healthy as they wanted to be,” she said. “I feel like I have a few good years ahead of me and I wanted to take care of myself in such a way that I could enjoy myself.”
She has lost 25 pounds in the past year, partly through a program at the Cleveland Clinic. She has improved her cholesterol, has started a plant-based diet and has begun exercising regularly.
“I’m not ready to go yet,” she said.
